De Autism 1.1: Introduction

Foreword: My supervisor had suggested that we all did some reflections with regards to the work that we did as well as of any related articles pertaining to that subject matter. To be honest, that was the only thing I remembered during the duration of that meeting; the flu bug having gotten the better of me. Anyway, I thought it was a great idea then and still do now in my already less dazed and less medicated state. It would certainly go well with the theme and purpose of this blog. And seeing also as I consider myself a fan of Aristotle's works, more specifically his De Anima Treatise, I would attempt to to create portions of my reflections here in a similar vein to one of Aristotle's more famous works. Attempt being the operative word.


Autism Spectrum Disorder (ASD) or autism for short is categorized as a pervasive developmental disorder within the Diagnostic Statistics Manual IV (DSM IV). Though that statement in itself is quite an oversimplification. Within the classification of ASD in the DSM IV, this disorder is further segregated into 5 different but not otherwise distinct segments which comprise of Rett syndrome, pervasive developmental disorder (not otherwise specified), childhood disintegrative disorder, autistic disorder and Asperger's syndrome. The newly proposed DSM 5 scheduled for release in 2013 however places all the above segments into a single category without segmentation, though Rett syndrome had been omitted from being part of the classification of the spectrum of this disorder. The change had been mostly due to the supporting basis for the segregation in DSM IV which was mostly founded upon personal stances and attitudes rather than empirical evidence. The symptoms that would qualify for a diagnosis for this disorder have also been reduced from 12 to 6 which further reflects this major reconceptualization (Johnny L. Matson & Peter Sturmey (Eds.), 2011). This is perhaps an attempt to streamline the different sub-categorizations into a single classification to further simplify the diagnostic process.

Regardless of how the disorder was or will be categorized, symptoms that will be persistently considered across the spectrum and in current and future diagnostic tools are that of problems with social communication and by extension social behaviour (Smith, 2012) and that of the lack of ability in generalizing or otherwise behaviour, tasks or objects for their intended purposes in a given setting or situation (Eric Shopler & Gary B. Mesibov (Eds.), 1986) would still be the proverbial benchmarks in identifying individuals with this disorder. Added to the above symptoms would be the somewhat apparent but more difficult to measure, sensory integration or perception issues in people with autism (Bogdashina, 2003). These would include intermittent rocking of the body, head shaking or seemingly inappropriate gestures, movements and verbalizations. Communication, as stated above, be it social or functional is definitely an issue in individuals with autism, regardless of the setting. Though I would propose the means in which they communicate which is regarded as an impairment when based against the norm, is in fact simply a significantly different way of communicating. And with the effort that people with autism take to learn and understand the communication rules, tools and means of us neurotypicals, some professionals who work within this field had even suggested that we should learn their ways of communication as well (Bogdashina, 2005). Though this would be difficult to be implemented as a general rule as individuals with autism present at times varied communication styles between them.

Why are such classifications necessary? There have been thoughts from some quarters, especially parents of people with autism who have questioned as to whether such classifications of their children would indeed be beneficial in terms of what help their child needed or would these labels further isolate them from being able to integrate with society at large (Ruth Cigman & Andrew Davis (Eds.), 2009). Most of such concerns had come about due to numerous cases of misdiagnosis of learning disabilities as far back as 3 decades ago (Jussim, 2012). This probably led to children who would otherwise be treated normally to undergo specialized educational approaches as well as possibly stressful interactions with individuals who would treat them in  a way that is defined by their label and not by the individual themselves. However to do away with any and all diagnostic classifications could be seen as a folly on the opposite end of the same pole. Proper and accurate diagnosis of autism, especially at an early age is encouraged (David G. Amaral, Geraldine Dawson & Daniel H. Geschwind (Eds.), 2011) as it has led to improved functioning for the majority of these children at a later stage in their life after participation of appropriate intervention methods (Eric Shopler, Nurit Yirmiya, Cory Shulman & Lee M. Marcus (Eds.), 2001). Another possible reason of why such classifications are necessary is due to the percentage of comorbidity that an individual with autism would have with another disorder, for example Attention Deficit Hyperactivity Disorder (ADHD). These classification methods help to identify which aspects of autism or the comorbidity that a the health or allied health practitioner would be looking to treat or assist upon improving (Chilvers, 2007).

As it stands there is no single abnormality that can account for all the impairments associated with autism and it's many forms. And although no body of research have managed to find a precise cause, there are however enough research done to establish some possible mechanisms of how autism can come about (Mash & Wolfe, 2010). Due to the research and advancements in technology, much of once unproven theories with regards to the causation of autism including celiac disorders, mercury poisoning, thiomerosol poisoning, brain allergies and bad parenting (Rtivo, 2006) have been disproven. The last of those theories having led to the formation of holding therapy or regulatory bonding therapy in order to improve the bond between a child with autism and their mother. It had been likened to some form of a sensory integration approach which provides deep pressure and intensive touch whereby the child would become acclimatized to the approach and thus then seek to communicate. Although there is no scientific basis for its effectiveness on children with autism, it has been used with varying degrees of success (Kurtz, 2008). What has been confirmed is that there are marked differences in the activity within the brain of a person with autism when compared to their neurotypical counterparts (Mesibov, Adams & Klinger, 1997). A recent prospective research whereby 104 infants ranging from 6 to 10 months old were exposed to faces that either looked at them or away from them and had their event-related potentials (ERP) recorded for each incident have brought about a possible means of detecting autism even earlier (Hudry, Chandler, Pasco, Charman, Pickles, Baron-Cohen, Bolton & Johnson, 2012). Perhaps with the development of more of such approaches towards detecting autism through neurological measures other than just based on presentation of symptoms would lead to a better reflection of the prevalence rate of autism in various countries. As it stands, the prevalence rate of autism in the United States is 1 in 88 (Zimmerman, 2012) and if one were to assume similar rates for other developed nations, then that is definitely approaching epidemic or even pandemic levels.

There isn't much that I can do from the scope of my current vocation with regards to the prevention of the occurrence of autism. However, as an individual who deems himself a professional assisting in the educational as well as therapeutic outcomes for people with autism, I personally feel that it is crucial for me to know the ways and means in which the disorder is diagnosed as well as the basis in which certain schools of thought for intervention were founded. As no single individual with autism is similar to another in terms of the behaviours they present as well as their motivations, it is important to use such general knowledge gathered through research to create as customized an intervention as possible in order to cater to these differences.


References:

Bogdashina, O. (2003). Sensory Perceptual Issues in Autism and Asperger Syndrom: Different Sensory Experiences Different Perceptual World. United Kingdom. Jennifer Kingsley Publishers. pp. 133 - 134.
Bogdashina, O. (2005). Communication Issues in Autism and Asperger Syndrome: Do we speak the same language?. London. Jessica Kingsley Publishers. pp. 15-17.
Chilvers, R. (2007). The Hidden World of Autism: Writing and Art by children with High-functioning Autism. London. Jessica Kingsley Publishers. p. 21.
David G. Amaral, Geraldine Dawson & Daniel H. Geschwind (Eds.). (2011). Autism Spectrum Disorders. New York. Oxford University Press. p. 1271.
Eric Shopler & Gary B. Mesibov (Eds.). (1986). Social Behaviour in Autism: Current Issues in Autism. New York. Plenum Press. pp. 358-259.
Eric Shopler, Nurit Yirmiya, Cory Shulman & Lee M. Marcus. (Eds.). (2001). The Research Basis for Autism Intervention. New York. Plenum Publishers. p. 159.
Hudry, K., Chandler, S., Pasco, G., Charman, C., Pickles, A., Baron-Cohen, S., Bolton, P., Johnson, M.H. (2012). Infant Neural Sensitivity to Dynamic Eye Gaze is Associated with Later Emerging Autism. Current Biology, Vol 22(4), 338-342.
Johnny L. Matson & Peter Sturmey (Eds.). (2011). International Handbook of Autism & Pervasive Developmental Disorders: Autism and Child Psychopathology Series. New York. Springer. p. 23.
Jussim, L. (2012). Social Perception and Social Reality: Why Accuracy Dominates Bias and Self-Fulfilling Prophecy. New York. Oxford University Press. p. 136.
Kurtz, L.A.(2008). Understanding Controversial Therapies for Children with Autism, Attention Deficit Disorder & Other Disabilities. London. Jessica Kingsley Publishers. p. 77.
Mash, E.J., Wolfe, D.A. (2010). Abnormal Child Psychology; Fourth Edition. Canada. Wadsworth. p. 317.
Mesibov, G.B., Adams, W.L., Klinger, L.G. (1997). Autism: Understanding the Disorder. New York. Plenum Press. p. 58.
Ritvo, E.R. (2006). Understanding the Nature of Autism and Asperger's Disorder: Forty Years of Clinical Practice and Pioneering Research. London. Jessica Kingsley Publishers. p. 118.
Ruth Cigman & Andrew Davis (Eds.). (2009). New Philosophies of Learning. Malaysia. Wiley-Blackwell. pp. 131-133.
Smith, T. (2012). Making Inclusion Work for Students with Autism Spectrum Disorders: An Evidence-Based Guide. Springer. New York. pp. 43-44.
Zimmerman, R. (2012). Breaking News: CDC Estimates U.S. Autism Rate Up To 1 in 88 Kids. Common Health: Reform And Reality. Retrieved from: http://commonhealth.wbur.org/2012/03/breaking-news-cdc-estimates-u-s-autism-rate-up-to-1-in-88-children on 24th April 2012.

The 4 WH's of Psychology

I've had always wanted to set up this blog to both provide an extra avenue (and hopefully additional impetus) for me to write first and foremost and by default comment in a psuedo-academic manner on recent studies and findings that I would come across during my literature review or through random reading based on the various schools of thought within psychology. And since I am a student of this very discipline, I figured this would also assist in lubricating my ability in doing up assignment papers in preparation for my final year dissertation.

As this is the maiden post on this blog, I thought it would be prudent for me to explain, for the most part and hope to provide fun facts along the way, the What, When, Who and most importantly Whys of Psychology through my understanding of this discipline and in the context of the reasons for my interest in it.

WHAT is Psychology?

For those of you who are too constrained by time to Google or Wiki the definition, it simply states that "Psychology is defined by the study of the mind, which is partly done through the study of behavior." (American  Psychological Association, 2012). 

The word "psychology" in it's Latin form psychologia literally means "the study of the soul". It is formed through the Latin words psukhe, meaning "breath", "soul", "spirit" and logia which means "study of" or "research". (Online Etymology Dictionary, 2001). Since the concept of the "soul" or "spirit" was perhaps deemed unscientific and leaned too much into theological understanding, the meaning of the word psukhe had been made interchangeable with a more scientific concept, in that of the "mind". Although the common understanding of psychology limits it to the study of human behavior, there are also branches in psychology that study the behavior and by extension the mind of animals both for the purposes of understanding human behavior better (through the study of our primate cousins) as well as to better understand the behaviors of the animals themselves.

There are numerous branches of study or schools of thought if you will, within Psychology itself each with it's own unique basis and approach, empirical or otherwise at explaining a multitude of behaviors. Due to the non-empirical nature of some schools of thought, psychology may still be seen as a pseudo-science by other medical or scientific disciplines, though recent efforts through proper research have sought to reverse this mindset.

WHEN did Psychology first come to be and WHO came up with the idea of it?

The first ever mention of psychology in English was by Dutch physician Steven Blankaart in 1694 in which he stated "Anatomy, which treats of the Body, Psychology, which treats of the Soul." within The Physical Dictionary.

Dr. Sigmund Freud

Some psychologists of varying disciplines would credit Dr. Sigmund Freud as the founder and pioneer of psychology as a discipline. His studies on hysteria and neurosis as well  as the formation of a system of therapeutic approach, namely Psychoanalysis, in the years 1880 to 1882 (Rycroft, 1995) were then considered a breakthrough in addressing cases of hysteria and neurosis without the use of prescription medication or surgical treatment. It was also the first known scientifically published paper on an approach to treatment which we have come to identify in contemporary terms as counseling. This therapeutic means however did not come without its critics whose main gripe is its lack of compatibility with scientific approaches to the study of the mind due to its interpretative nature (Patrick Grim (Ed.), 1990).  

Dr. Ivan Pavlov

Psychologists with more of a slant towards biological causation for behavior would more likely point to Dr. Ivan Pavlov as the eminent individual who had first discovered and shed light on the possible causes for behavior through empirical research. He is most famous for his findings on "conditioned reflex" in 1901 which was formulated after observing the behavior of dogs salivating when the main stimuli, food was paired with a second stimuli, the ringing of a bell. Due to the consistent pairing of both stimuli, the dogs began salivating at the sound of the ringing bell even though no food were presented (Todes, 2002). A web-based game was even created based on this Nobel Prize winning research.

This gave rise to and was expanded into the theory of Classical Conditioning which is now accepted one of the numerous means in which humans and other animals learn behavior.

Dr. Edward L. Thorndike

Proponents of Behaviorism however may credit Dr. Edward Thorndike as the individual that had illuminated the scientific community on the existence of psychology. His works in the modification of behavior namely through his Law of Effect theory through his studies with cats, boxes and the felines attempts at escape from them through his published paper (Thorndike, 1901). It basically states that behaviors which produce a desired outcome would more likely reoccur when compared with behaviors that do not produce a desired outcome. Which in the case of the cats being trapped in their boxes meant the pulling of the lever to facilitate their release rather than scratching, digging and meowing behaviors.Thorndike's theories were further expanded by behaviorists, namely Dr. B.F. Skinner into the Operant Conditioning theory which basically involved three concepts, namely Reward, Punishment and Extinction whereby the first two are reinforcements while the third is a state by which the behavior does not present itself due to the lack of or proper implementation of reinforcement methods. This led to a wave in behaviorist thinking and approaches as it appeared that through proper scheduling of reinforcement and the purported amount, one may either increase desired behavior or decreased undesired behavior to the point of extinction. Although some may prefer to state that there is a dichotomy between Pavlovian conditioning as mentioned above and Operant conditioning, there are however instances where in lieu of sufficient reinforcement significance that Classical Conditioning occurs instead (Gardner & Gardner, 1988) thus indicating that both to work hand in hand in the process of learning.

Although most of these were scientific research, predominantly of Western influence, the concept of psychology predates even the philosophical musings of Aristotle and his De Anima treatise, circa 1362 with studies of the brain and the mind done in ancient civilizations of Egypt, India, China and Greece. I would even dare to suggest that the concept of psychology predates any treatise, book or parchments that could be found as I believe that the study of the mind and of behavior is much entwined with our very nature as human beings to study our own nature. Dare I even say that the concept of psychology was first thought of by our very distant and ancient human ancestors, who may well be, our Adam and Eve, if I were this borrow a concept from Judeo-Christian and Islamic traditions.

WHY study Psychology?

Why not psychology? 

I had always been interested in and loved knowledge and the facts pertaining to that knowledge. Be it from animal sciences to quantum physics to medical sciences, I loved knowledge. So in that sense perhaps I would be better defined as philosopher or as a "lover of wisdom" in the Latin meaning of the word. And to a great extent my deep interest in philosophy was further augmented due to the complex nature of the questions posed as well as the complex nature one would be able to derive an answer to the simplest question and the complexity of the answer itself. Personally, I see psychology as the extension of philosophy, in that it attempts to answer the same questions but through empirical and replicable means. 

It is also a means by which we would acquire answers through research and with the application of those answers would be able to give rise to a better life for all, which was and still is my ultimate goal. Idealistically naive, I know but that is, as I now have come to confirm, is my nature. This is another aspect of psychology that entices me, in that it empowers me to learn, understand and know of myself and the behaviors that come with through the many different schools of thought that it offers. 

"For in knowing do we then aspire to better." as my idealistic self would say.

References:

American Psychological Association. (2012). How does APA define "psychology"?. Retrieved on 19th Feb 2012.

Gardner, R.A., Gardner, B.T. (1988). Feedforward vs feedbackward: An ethological alternative to the law of effect. Behavioral and Brain Sciences Vol. 11 (429-447).

Online Etymology Dictionary. (2001). Psychology. Retrieved on 19th Feb 2012.

Patrick Grim (Ed.). (1990). Philosophy of Science and the Occult (2nd Ed). Albany. State University of New York Press. pp. 104-110. 

Rycroft, C. (1995). A Critical Dictionary of Psychoanalysis. London. Penguin Books. pp. 185-186.

Thorndike, E.L (1901). Animal Intelligence: An experimental study on the associative processes in animals. Psychological Review Monograph Vol 2 (1-109).

Todes, D.P.. (2002). Pavlov's Physiology Factory. Baltimore. Johns Hopkins University. pp. 232.